Prolotherapy for my Hamstring Tendon Injury

My Family Practice doctor referred me to a new Sports Injury doctor and now I have embarked on a series of injection treatments to my hamstring tendon injury called Prolotherapy. He explained to me that a tendon does not have a very good blood supply and therefore heals extremely slowly. The thought behind Prolotherapy is to inject a benign substance into the torn tendon site which causes an inflammatory reaction in the area, causing blood and plasma to rush to the area, providing it with the necessary components to facilitate tissue building and faster healing and thereby also helps to reduce pain. This type of treatment is not covered by medical insurance so it is an out of pocket treatment which has not been officially recognized as being effective. However I thought it was worth a try. I was given two options, the first being the more expensive option of having my blood drawn, then having it spinned to separate the plasma from the red blood cells and then having my own plasma re injected into the injury site. This option would run into hundreds of dollars per treatment. The second option was to have a sterile dextrose solution injected into the tendon injury site, which would cause the same type of inflammatory response and would be significantly less expensive, so I opted for this choice.

The procedure consists of finding the tendon insertion site via ultrasound and then doing a guided injection into the injury site. I can say that being injected into the ischial tuberosity area is no picnic. The actual insertion of the needle is not painful but once the solution is being injected into the injury it is extremely painful and just awful and a weird sensation. My Sports Injury Physician told me to expect it to feel worse for a couple of days after the treatment and he was right, it was so painful that it kept me awake at night and I vowed after the first treatment that I would not go back for more but on the third day following the injection I woke up surprised to find that it actually was feeling a bit better. This scenario was played out two more times and I am going for my final treatment next week. I was instructed only to do light exercise during the course of the treatment and this week I have started at the beginning of an 18 week program to train for another marathon, which involves a gradual build up of miles.

In summary so far I feel that there has been some value to having received Prolotherapy as I have noticed a reduction in pain and am able to run again without the extreme discomfort I was experiencing before. After my final injection and once my marathon training program advances I hope to really reap the benefits of it. I would also like to add that it really makes a difference to have a doctor who is interested in helping his patients become well again so that they can resume an active lifestyle.

My final entry on this subject after my 4th treatment ( approximately 2 months after the first injection) is that my injury is significantly improved and I would recommend this as a treatment modality based on my own experience....time to hit the trails!

From 4 miles to 150 miles "Racing the Kalahari": My story published in Marathon & Beyond magazine

Super stoked to announce that one of my running stories has been published in the 100th edition of Marathon & Beyond running magazine. It relays not only my account of participating in the 150miles/250km Kalahari Augrabies Extreme Marathon but also the events leading up to it, starting with me feeling as though 4 miles was a 'long run'.

Story can be read from page 144-153

Planning to live out of a backpack for 5 months...

My PCT thru hike gear

One of the most daunting tasks of planning to hike the full 2,650 miles of the Pacific Crest Trail is deciding what to take. There are certain 'must haves' in order to survive it and the rest is all going to be food. One has to consider the weight of carrying everything for miles upon miles and from all the research I've done I've come to the conclusion that going light is the best choice.
List of essentials:
1) Shelter
2) Backpack
3) Sleeping Bag
4) Sleeping pad
5)Sleeping clothes
6) Stove and cook pot
7) Water treatment
8) Water containers
9) Compass
10) Maps and data book
11) Pack cover
12)4 layers of clothing:
 a) Base: poly ether thermal underwear
 b) Summer: hiking shorts/polyester shirt
 c) Warmth: fleece pants/ down vest
 d) Wind and rain: rain jacket/ rain pants
13) FOOD!!! 3000ca/day mostly dehydrated food items and light weight

So far I have the following and not in any particular order as I'll add them as I get them:

1) TENT: (my shelter for 5 months of sleeping on a wilderness trail).
I have decided to go ultralight and invested in a one person 'Big Agnes Fly Creek UL1' with only weighs 1lb 4oz

Manufacturer description:

Single hub pole assembly and plastic pole clips ensure a hassle-free setup; fabric loops along the ridge pole decrease weight

Lightweight and strong DAC® pole system with press-fit connectors and lightweight hubs uses an anodization process without harsh acids

Rain fly and seamless floor are made of high-tenacity ripstop nylon and are both polyurethane- and silicone-coated for waterproof durability

Walls are constructed of woven nylon mesh, providing excellent ventilation and 360° views

All seams are taped with waterproof, solvent-free polyurethane tape

Reflective guy out and reflective webbing on tent corners increase visibility at night

On warm cloudless nights the tent can be set up basically to view a trillion stars

Perfect for one and a backpack

Set up to withstand the elements

2) BACKPACK:
I decided on the ULA Catalyst, a tried and tested lightweight workhorse of a pack.
Specs:

Main Body: 2,600

Front Mesh Pocket: 600

Side Mesh Pocket: 350 ea

Ext. Collar: 600

Hip belt Pockets: 100

Total Volume: 4,600 cu in

Made in USA and assembled according to your specific requirements. I got the purple haze

3)GUIDEBOOKS, MAPS AND DATA BOOK:

From various different sources I have decided that these are absolute necessities. Most of the trail sounds like it's easy to follow but there are some junctions that may cause confusion and other areas, especially in the high Sierras that may be snowed over. Due to their weight, you can only hike with one at a time and either have the others mailed to you to areas where you'll need them, or you can mail them in a bounce box that you mail to yourself along the way.
The guidebooks I purchased have the descriptions and maps in them. The data book lists all the landmarks, water availability, mileage between landmarks, cumulative mileage and elevation.

4) STOVE AND POT:
I bought this high tech, light weight combined stove and pot at the REI in San Francisco and haven't got the faintest idea how to use it yet....I'd better learn soon!

5) SLEEPING BAG:
 I bought my sleeping bag along with my backpack from ULA. I needed something warm and the ultralight bag I had for the Kalahari adventure would have left me freezing in any snow or frost conditions. This did seem a little heavy, but I want to be warm when I'm sleeping. There are so many sleeping bag options out there it makes the mind boggle, so I went with this one and I'm sure it'll be worth the weight.
Specs:
Sharks Tail shaped foot box
5 baffle foot box - 2 horizontal, 3 vertical
Stretch baffles, below the shoulders
3D Interlocking Draft Tubes
¾ length zip with guard
Anatomical Hood
Super Soft and lightweight liner.
Lightweight breathable fabrics
Neck collar to minimize heat loss
Ships with large mesh storage sack

Specs.

20 Degree
550 Down Sleeping Bag
2.59 lbs
84.5" x 31.5" x 21.

This silk sleep sack makes your sleeping bag 10 degrees F warmer

Extremely warm in this cocoon

Planning for a BIG adventure ....The PCT

I have a dream.....to do the entire Pacific Crest Trail, a 2.650 mile (4264 km) continuous wilderness hike from Mexico to Canada which takes you through California, Oregon and Washington. The start of this extreme endurance "walkabout" is at the small border town of Campo on the California/Mexican border and ends at Manning Park on the Washington/Canadian border. I estimate that I would be able to manage backpacking 20 miles/day (32km/day) which would make the hike last 5 months, living completely on the trail with only what I can carry on my back. There are various towns one can hike down to along the way where you can replenish your food supplies by either purchasing them or having someone mail boxes to the postoffices and labelling them "PCT Thru Hike"...apparently they keep the boxes for at least a couple of weeks to be picked up by hikers.

I don't know anyone personally who wants to do the entire trail in one go, nor anyone who has the ability to take 5 months off life, so I am embarking on this journey solo. Of course there will be times that I meet other hikers along the way and see people when I hike down into towns. Some friends are planning to meet up with me and do short sections of the hike with me, but the majority of the time I shall be in my own company , in the wilderness and I'm sure this is going to have a profound impact on my life. According to information I have gathered on the internet, about 300 people set out to do the "thru hike" each year and about 50 people actually manage to complete the entire trail in one go.  April is the time to start to meet optimal weather conditions as you start out and reach the different stages in the trail, most noteably, the high Sierras which are often covered in thick snow and ice which I am totally unfamiliar with since I have spent my entire life in southern Africa and on tropical islands. By rough estimation, I should complete the journey in September.

Map of the PCT

My preparation so far has been reading up as much information about the Pacific Crest Trail as possible and reading various books about endurance hiking, including the entertaining "A Walk in the Woods" by Bill Bryson, the compelling "Wild" by Cheryl Strayed and the hilarious "The Cactus Eaters: How I lost my mind and almost found myself on the PCT" by Dan White.

My one and only real life mentor who has previuosly completed the PCT through hike is my friend Atomic (trail name). He very graciously sent me the guru's guide on how to do this in the form of "Yogi's PCT Handbook" which I am studying religiously. This book gives the hiker insight into everything from what gear to use, to the food you need, to hints and tips about camping, obtaining water and what to expect including the good, the bad and the ugly....which turns out to be nasty microscopic bacteria (giardia) in contaminated water sources.

One of the other characteristics of becoming a PCT thru hiker is getting a trail name. This name can only be bestowed upon you by other hikers you encounter and is usually given for a specific reason such as a physical characteristic or part of your character or an event. I am interested to find out what mine will be.

Part of the immense fun of planning is of course deciding upon and obtaining the necessary gear to pack. Bearing in mind that I am a 5ft 4in woman, I shall be going the "ultralight" route. Living in Hawaii certainly poses a lot of limitations on easy access to a lot of this type of gear, so I'm looking really forward to my trip to Portland, Oregon next week so that I can go and do some' backpacking shopping' at the outdoor sports megastore REI...this is going to be a really fun side activity to an already action packed fun week at the Portland Tango festival...a week of non-stop lessons and milongas in the  addicting art of Argentine tango. I'll be updating my blog on gear once I get back. Hoping to come home with an ultralight tent, ultralight 25 degree F (-3.88889 degrees celcius) sleeping bag and some ultralight cold weather hiking clothing.

This author did the PCT in 2 sections, 2 years apart. I found the first half of the book interesting and then I lost interest during the second half. She hand sketches all the drawings in the book which is quite nice. Useful, but not riveting.

Volunteering for H.U.R.T 100 mile endurance race

Giving back to the running community by volunteering at a race:

What an inspirational weekend! I had the absolute privilege of volunteering the 'night shift' at the HURT 100 mile trail race at the awesome "Pirates in Paradise" aide station for the second year in a row.It was so fabulous being able to help make these incredible endurance athletes dream of completing this very difficult race become a reality. I am in awe of how wonderful the Hawaii ultra running community is, nicer people living the spirit of aloha you will not find. The dedication of the race committee, volunteers and aide station directors is commendable. Congratulations to everyone who finished the 100miles/100k and to all of those who attempted it. You all rock and I am extremely happy to have been a part of it in a small way.

As one of my running friends stated, no-one actually knows what hard work and dedication is involved in volunteering for a race. As a runner, you appreciate it but you don't really understand what it entails until you do it yourself. I recommend that all runners volunteer at some point, it's a very rewarding experience.

It was equally exciting to see the elite front runners smash records and their own personal bests as it was to see the other end of the spectrum with competitors struggling through their obstacles to make it just within the cut off time.

I have to admit to feeling so inspired that the thought entered my mind that I may want to attempt this particular gruelling race at some point in my future. It certainly inspired me to desire to revisit the Peacock 100K in october.

Out of the 131 entrants, 53 finished the 100 miles within the 36 hour cutoff, the fastest man (Gary Robbins) finished in 19:35, and woman (Hannah Roberts) in 25:41. A total of 46 men finished and 7 women. Many of the athletes were recognized for completing 100K (the fun run).

One of the interesting observations I made while serving the runners food was the amount of requests I recieved from runners and pacers alike for vegan options. This was of particular interest to me as I follow a vegan diet myself and usually feel like I'm in the complete minority which obviously isn't the case any more if this trend was anything to go by.

Aloha and ahoy there me matey!

My 'Pirates in Paradise' volunteer outfit

There is also a H.U.R.T (Hawaii Ultra Running Team) Cook Book newly available called "Eat drink run repeat".This is a compilation of recipes submitted by the HURT ohana (family) of runners, including myself.  Anyone interested can search for it on the HURT website.

I'm also very happy to report that I am slowly getting my running groove back. My torn left hamstring tendon is gradually feeling a little more comfortable and I managed to run in the Honolulu Marathon again in december. I viewed it as a slow, catered for training run and had a lot of fun with friends. So here's to 2013 being a better year for me in terms of racking up the miles. I'm setting my intentions and building on what I have in a positive and constructive manner.

 

 

The World's Toughest Endurance Challenges

I just discovered that there is a photograph of me slogging it out through the Kalahari Desert on page 6 of this book! Cool....and I've completed 2 of the races mentioned in the book. Now I'm motivated to sign up for the next one!
http://issuu.com/BloomsburyPublishing/docs/theworld_s_toughest_endurancechallenges/7

This is the pic:

One year since my horrible hamstring injury

It's been a year since my awful hamstring tendon injury...a tough and painful year at that!
I'm still in pain, however the severity has diminished and it's the most severe after prolonged periods of sitting, like driving a car for 20 minutes or more as I am placing pressure on the injury and stretching it in this position. I was completely incapacitated the first 3 months following the tear of my hamstring tendon at the ischial tuberosity insertion site, after which I started walking and slow jogging and built up to 2 marathons in April (6 months after the injury). I could feel that the injury was still pretty severe after this and decided to get an MRI to ascertain the severity of the injury. I thought they (the medical professionals) would tell me that I was being a baby and that nothing would show up on the MRI, but instead I discovered that I was not a baby and that I did indeed have a very nasty injury. The orthopedic surgeon/sports medicine doctor I was referred to was absolutely awful. He had zero personality, zero compassion, was completely disinterested in my case and basically just gave me a referral to get an MRI. His nurse was even worse and actually threw the pamphlet for the MRI service at me and told me to make the appointment myself. Neither of them made eye contact with me at all during my consultation and both were obviously very miserable with their own existence. Regardless I had the MRI and the result was as follows:

"Left hamstring origin is thickened. The semimembranosus origin remains intact but the conjoint tendon (combination of the long head biceps femoristendon and semitendinosus tendon) are torn from the ischial tuberosity.... Small region of fluid between the conjoint tendon and the ischial tuberosity....there is some enthesopathic change in the ischial tuberosity. There is T2 prolongation in the anterosuperior labrum compatible with at least degeneration. In the radial sequence, anterosuperior labrum is probably torn."

Basically this means that my left hamstring is completely damaged at the hamstring insertion site into my sitting bone and it has torn away from the bone.

Here is a diagram of what tore off the bone:

Response from the lovely doctor. "There is nothing you can do for this sort of injury and it does not require surgery. If you want to do physical therapy you can." He then went on to say that he would only refer me to a certain physical therapist in Honolulu itself who I would not be able to make appointments with on a regular basis given that I live 40  miles away and work many hours, making it inconvenient and not sustainable.

So I've been treating myself with a combination of acupuncture, chiropractic sessions, massage, stretching, strength building exercises,fast walking, progressing on to slow jogging combined with cycling. The jogging and cycling I've slowly been increasing in distance and feel that the injury is status quo, maybe improving slightly and feeling slightly inflamed after an exercises session but not significantly worse....and let us not forget Tango! Dancing has kept me sane throughout this long rehabilitation process and I am so thankful for it.

So here's hoping and working towards continued improvement and more adventures in my future!